Why Include Arthroscopy in the Management of Certain Types of Distal Radius Fractures?
Marion BURNIER | GH Guillaume HERZBERG
Seance of wednesday 22 january 2025 (Chirurgie du poignet)
DOI number : 10.26299/khq0-et17/emem.2025.03.02
Abstract
Distal radius fractures are the most common type of fractures, affecting a heterogeneous population ranging from young, active individuals to elderly osteoporotic patients. Their prevalence and functional impact make them a significant public health concern. The management of these fractures varies according to the general condition and functional needs of the patient.
In younger individuals, these fractures often result from high-energy trauma and are frequently associated with intra-articular damage and ligamentous injuries. Computed tomography (CT) plays a key role in assessing the complexity of the fracture patterns and optimizing surgical planning. Anatomical restoration of the distal radial epiphysis is crucial for preserving carpal alignment, minimizing articular wear, and preventing post-traumatic osteoarthritis.
Advances in osteosynthesis techniques, particularly the use of volar locking plates, combined with improved anatomical understanding, have enabled reductions that closely approximate the ideal anatomy. Additionally, arthroscopic assistance, which has significantly evolved over the past decade, offers substantial added value in the management of these fractures. Arthroscopy allows optimal management of associated injuries, such as hemarthrosis, intra-articular loose bodies, and ligamentous lesions, while providing direct control of the articular reduction, with the ability to refine it intraoperatively as needed.
In this session, we will present the results of our prospective study comparing the clinical and CT outcomes of intra-articular distal radius fractures treated with and without arthroscopic assistance. This analysis highlights the benefits of arthroscopy in improving the quality of care and functional outcomes in active patients.
Marion Burnier, Guillaume Herzberg (Lyon)
In younger individuals, these fractures often result from high-energy trauma and are frequently associated with intra-articular damage and ligamentous injuries. Computed tomography (CT) plays a key role in assessing the complexity of the fracture patterns and optimizing surgical planning. Anatomical restoration of the distal radial epiphysis is crucial for preserving carpal alignment, minimizing articular wear, and preventing post-traumatic osteoarthritis.
Advances in osteosynthesis techniques, particularly the use of volar locking plates, combined with improved anatomical understanding, have enabled reductions that closely approximate the ideal anatomy. Additionally, arthroscopic assistance, which has significantly evolved over the past decade, offers substantial added value in the management of these fractures. Arthroscopy allows optimal management of associated injuries, such as hemarthrosis, intra-articular loose bodies, and ligamentous lesions, while providing direct control of the articular reduction, with the ability to refine it intraoperatively as needed.
In this session, we will present the results of our prospective study comparing the clinical and CT outcomes of intra-articular distal radius fractures treated with and without arthroscopic assistance. This analysis highlights the benefits of arthroscopy in improving the quality of care and functional outcomes in active patients.
Marion Burnier, Guillaume Herzberg (Lyon)